Right heart cath systolic PA pressure
Enter systolic PAP.
Right heart cath diastolic PA pressure
Enter diastolic PAP.
Pulmonary capillary wedge pressure
For PVR calculation (requires PCWP)
Direct measurement overrides calculated value
Mean PAP (mPAP)
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⚠️ Medical Disclaimer: PH diagnosis and classification requires full clinical assessment by a pulmonologist or cardiologist with complete RHC data and clinical context. This calculator is for educational reference only.
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Sources & Methodology
Formulas and PH classification per ESC/ERS 2022 Pulmonary Hypertension Guidelines (European Heart Journal).
ESC/ERS 2022 Pulmonary Hypertension Guidelines — European Heart Journal
Updated PH definition (mPAP above 20 mmHg), PVR threshold (above 2 WU), and 5-group classification. academic.oup.com/eurheartj
American College of Cardiology / AHA — Right Heart Catheterization Standards
RHC measurement protocols and hemodynamic normal values. acc.org
Simonneau G et al. — Updated Hemodynamic Definitions (Eur Respir J 2019)
Review of hemodynamic criteria for PH classification prior to 2022 ESC update.
mPAP = dPAP + 1/3 x (sPAP - dPAP) or (sPAP + 2 x dPAP) / 3
TPG (mmHg) = mPAP - PCWP
DPG (mmHg) = dPAP - PCWP
PVR (Wood units) = (mPAP - PCWP) / CO
PH defined: mPAP above 20 mmHg (ESC/ERS 2022)
TPG (mmHg) = mPAP - PCWP
DPG (mmHg) = dPAP - PCWP
PVR (Wood units) = (mPAP - PCWP) / CO
PH defined: mPAP above 20 mmHg (ESC/ERS 2022)
PVR = (mPAP - PCWP) / CO
Example: mPAP 35, PCWP 12, CO 4.5 L/min.
TPG = 35 - 12 = 23 mmHg (above 12 = pre-capillary component).
PVR = (35 - 12) / 4.5 = 5.1 Wood units (above 2 = pre-capillary PH confirmed).
TPG = 35 - 12 = 23 mmHg (above 12 = pre-capillary component).
PVR = (35 - 12) / 4.5 = 5.1 Wood units (above 2 = pre-capillary PH confirmed).
Last reviewed: April 2026
How Is Pulmonary Artery Pressure Calculated?
Mean pulmonary artery pressure (mPAP) is the average pressure in the pulmonary artery throughout the cardiac cycle. Because the pulmonary artery spends approximately two-thirds of each cycle in diastole, mPAP is calculated as: mPAP = diastolic PAP + 1/3 (systolic PAP - diastolic PAP). This is equivalent to (sPAP + 2 x dPAP) / 3.
The ESC/ERS 2022 guidelines updated the definition of pulmonary hypertension from mPAP above 25 mmHg to mPAP above 20 mmHg at rest. This earlier threshold allows identification and treatment of patients at an earlier, more reversible stage of disease.
Hemodynamic Classification of Pulmonary Hypertension (ESC/ERS 2022)
| Definition | mPAP | PCWP | PVR | Category |
|---|---|---|---|---|
| Pre-capillary PH | Above 20 | At or below 15 | Above 2 WU | Groups 1, 3, 4, 5 |
| Isolated post-capillary PH | Above 20 | Above 15 | At or below 2 WU | Group 2 (left heart) |
| Combined pre+post-capillary | Above 20 | Above 15 | Above 2 WU | Group 2 (mixed) |
| Normal | At or below 20 | At or below 15 | At or below 2 WU | No PH |
TPG vs DPG — Which to Use?
Both TPG (mPAP - PCWP) and DPG (dPAP - PCWP) identify pre-capillary components in patients with post-capillary PH (left heart disease). DPG is more specific than TPG — it is less affected by elevated PCWP and high pulmonary blood flow. DPG above 7 mmHg with PVR above 2 WU indicates combined pre- and post-capillary PH, which has worse prognosis and may need PAH-specific therapy consideration.
💡 2022 ESC Update — What Changed: The PH threshold dropped from mPAP above 25 to mPAP above 20 mmHg. PVR threshold changed from above 3 WU to above 2 WU for pre-capillary definition. A new borderline range (mPAP 21-24 mmHg) was identified as elevated mean PAP — requiring monitoring even without meeting full PH criteria. Earlier detection enables earlier treatment of reversible disease.
Frequently Asked Questions
mPAP = dPAP + 1/3(sPAP - dPAP). It is the average pulmonary artery pressure throughout the cardiac cycle. Normal mPAP is below 20 mmHg at rest (ESC/ERS 2022).
mPAP above 20 mmHg at rest (updated from previous threshold of 25 mmHg). Pre-capillary PH also requires PVR above 2 Wood units. Earlier threshold allows earlier diagnosis and treatment.
PVR = (mPAP - PCWP) / CO. Normal below 2 Wood units. Elevated PVR above 2 WU indicates pre-capillary PH — pulmonary vascular disease causing increased resistance to flow.
TPG = mPAP - PCWP. Normal below 12 mmHg. TPG above 12 with PVR above 2 WU confirms pre-capillary PH. Important for distinguishing pre- from post-capillary PH in heart failure.
Pre-capillary: mPAP above 20, PCWP at or below 15, PVR above 2 WU — pulmonary vascular disease (Groups 1,3,4,5). Post-capillary: mPAP above 20, PCWP above 15 — left heart disease (Group 2). Treatment differs fundamentally.
Pulmonary capillary wedge pressure reflects left atrial pressure, measured by wedging a balloon catheter in a pulmonary artery. Normal: 6-12 mmHg. PCWP above 15 mmHg indicates post-capillary cause of PH.
Normal: sPAP 15-25 mmHg, dPAP 8-15 mmHg, mPAP 10-20 mmHg. mPAP above 20 mmHg defines PH by ESC/ERS 2022 criteria.
5 WHO/ESC groups: Group 1 (PAH), Group 2 (left heart disease), Group 3 (lung disease), Group 4 (CTEPH), Group 5 (unclear). Hemodynamic categorization into pre- vs post-capillary guides group assignment.
DPG = dPAP - PCWP. Normal below 7 mmHg. DPG above 7 with PVR above 2 WU indicates combined pre- and post-capillary PH in left heart disease. More specific than TPG for identifying true PVD.
Yes. RHC is the gold standard for definitive PH diagnosis. Echo screens for elevated RVSP but cannot provide direct mPAP, PVR, or PCWP needed for definitive diagnosis and treatment decisions.
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